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General NPI Number Information
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NPI Number | 1114532561
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Entity Type | Organization
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Legal Business Name | NEFESH COUNSELING, LLC
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Dates
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Enumeration Date | 09/12/2020
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 3320 W FOSTER AVE # 124
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City | CHICAGO
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State | IL
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Zip | 60625-4813
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Country | US
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Telephone | 773-645-1443
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Fax |
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Provider Business Mailing Address
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Address Line | 3320 W FOSTER AVE # 124
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City | CHICAGO
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State | IL
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Zip | 60625-4813
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LCPC
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Name | LISA TAMAR PROVORNY
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Credential |
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Telephone | 773-645-1443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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